Deyrtii 2015, Doron Broman oo 44 jir ah ayaa laga helay kansarka ganaca -waxana la yaabay markii la ogaaday in kansarkiisa ganaca uu ka soo baxay buro weyn oo beerka ku taal. Isagoo wajahaya muddo badbaado ah oo dhowr bilood ah, Broman wuxuu go'aansaday inuu waqti xaddidan ku qaato meesha saxda ah.
Broman was diagnosed with metastatic kansarka ganaca da'da 44
Isagu waa nin soo saare ka ah dhismeyaasha guryaha ee ku yaal Miami, gurigiisuna waa Boston. Kadib markuu cilmi baaris ku sameeyay khadka tooska ah, wuxuu go'aansaday inuu ku daaweeyo Dana-Farber. Dhakhtarkiisa Kimmie Ng, MD, MPH, oo ah agaasimaha cilmi-baarista kiliinikada ee Xarunta Daaweynta Kansarka Gastrointestinal, waxay ku talinaysaa habka FOLFIRINOX, kaas oo ah kiimiko isku-darka ugu xooggan ee kansarka ganaca. Kansarka ganaca waa daawaynta ugu caansan.
Broman waxay ka duushay magaalada Miami kuna sii jeeday Boston labadii usbuucba mar si loogu daaweeyo. Qof walbana wuu layaabay, xumaantii ku dhacday beeryarada iyo beerka wuxuu bilaabay inuu si dhakhso leh u yaraado.
“This is the most significant response,” Ng sighed. “Several tumors almost completely disappeared after chemotherapy. This makes us wonder if there is a molecular mutation in his buro that makes it particularly sensitive to FOLFIRINOX.
Dhakhaatiirta kansarka waxay bilaabeen inay raadiyaan isbeddello aan caadi ahayn oo meco ah ama isbeddello ku yimaada koodh-siinta DNA-da burooyinka, maxaa yeelay waxay arkeen bukaan si weyn u hagaajinaya daawooyinka kansarka, daawaduna badanaa waxay leedahay jawaab dhexdhexaad ah ama wax faa iido ah uma lahan bukaanada kale ee cudurka qaba. These types of patients are called “special responders.” In the era of precision medicine, sequencing DNA from cancers of special responders may identify rare mutations, making patients ‘tumors extremely sensitive to specific drugs.
Kansarka Broman wuxuu si aad ah uga jawaabey daaweynta uu ku taliyay Kimmie Ng, MD.
Broman happened to arrive at Dana-Farber treatment just after Ng and her colleagues just started a new research protocol, allowing patients to perform additional biopsies to obtain genetic material that can be treated with precision medicine. Broman agreed. The entire exon sequence of his tumor DNA revealed mutations in the BRCA2 gene. When this mutation is inherited by women, it will greatly increase the risk of breast and kansarka ugxansiduhu. But Broman did not inherit the Isbedelka BRCA2 -waxay ahayd uun waqti uun noloshiisa, unugyadiisa beeryarada si aan kala sooc lahayn u lahaa isbeddelkan.
BRCA2 mutations can interfere with a cell’s ability to repair DNA damage, causing the cell to destroy itself. Cancer cells with BRCA2 mutations are particularly sensitive to platinum-based chemotherapeutic drugs based on DNA damage, which is part of the FOLFIRINOX protocol. This may explain why Broman ‘s cancer has been hit so successfully.
Kadib 13 wareeg oo daaweyn ah FOLFIRINOX, Broman wuxuu sifiican ugajawaabay daaweynta waxyeelo sida timo luminta iyo dhaawaca dareemayaasha, sidaa darteed kooxdiisii caafimaad waxay go'aansadeen inay u badalaan daroogo la bartilmaameedsaday oo la yiraahdo olaparib oo la yiraahdo PARP inhibitor (Lynparza) wuxuu hor istaagi karaa hagaajinta dhaawaca DNA .
"Olaparib waxaa loo ansixiyay kansarka ugxansidaha ee la xiriira dhaxalka BRCA-2," ayuu yiri Ng. "Si kastaba ha noqotee, burooyinka [aan dhaxalka lahayn] ee BRCA2-mutated, ma jiraan wax xog dhab ah oo ku saabsan kaalinteeda."
Sidaa darteed, Broman waxay joojisay FOLFIRINOX oo hadda waxay qaadataa 12 maalin kasta. Waxa uu sheegay in aysan jiri doonin wax dhibaato ah. Lix bilood ka dib borotokoolkiisa cusub, baarista MRI iyo CT ma muujin wax kansar ah oo soo noqnoqday, iyo heerarka biomarker-ka dhiigga ee kansarka ganaca ayaa ku haray xadka caadiga ah. Ng waxa uu sheegay in qorshihiisa uu yahay in uu si joogto ah u qaato qaadashada daawada ilaa inta uu kansarku xakamaynayo oo uu leeyahay waxyeellooyin yar.
Broman ayaa yiri: "Runtii aad ayaan u faraxsanahay". Wuu tukaday maalin kasta tan iyo markii uu is cadeeyay. Dhawaan wuxuu u safray Yurub iyo Israel halkaasoo uu ku dhashay. Waxaan qabtay wax aad uga fiican sidii aan filayay. Waxaan dareemayaa wanaag, timahaygii waa soo noqdeen, waan caafimaad qabaa, waxaan lugeeyaa 12 mayl maalintii, Sabti iyo maalin. Saaxiibbaday waxay dhaheen way rumaysan kari waayeen. ”
For Ng and her colleagues, she said that Broman ‘s case “points out that precision oncology and targeted therapy based on its molecular characteristics benefit cancer patients greatly.”
